Authors of
an article published
online in Medicine and Science in Sports
and Exercise say their finding of greater hip adduction in female runners
who develop patellofemoral pain (PFP) is in agreement with previous cross
sectional studies. These results suggest that runners who develop PFP use a
different proximal neuromuscular control strategy than those who remain healthy.
Injury prevention and treatment strategies should consider addressing these
altered hip mechanics, they add.

For this investigation, the authors conducted an instrumented
gait analysis on 400 healthy women runners and tracked them for any injuries that
they may have developed over a 2-year period. Fifteen cases of PFP developed,
which were confirmed by a medical professional. The participants' initial
running mechanics were compared with an equal number of runners who remained
uninjured.

According to the results, the runners who developed
PFP exhibited significantly greater hip adduction. No statistically significant
differences were found for the hip internal rotation angle or rearfoot eversion.

APTA
member Brian Noehren, PT, is the
article's lead author. APTA member Irene
Davis, PT, PhD, FAPTA, is coauthor.

Comments

Reading this summary, I thought, '"what came first - the chicken
or the egg". If a runner complains of PPF pain, and concurrently,
evaluation reveals excessive hip adduction - did the increased
hip adduction pre-exist the knee pain and thereby cause the
biomechanical problem resulting in PPF? Or did the PPF - for
whatever reason - cause an altered running gait and secondarily
result in excessive hip adduction? Food for thought.

Posted by Herschel Budlow P.T.
on 1/13/2013 3:42 PM

We would suggest that adduction is a result of glut med weakness due to biomechanical dysfunction of the lumbopelvic region.

Posted by Acceleration Physical Therapy
on 1/14/2013 12:45 AM

This was a prospective study, so the women were originally healthy, with no reports of pain. Then, over the course of 2 years, developed PFP. So, the implication is that the increased hip abduction predisposed the women to development of PFP, not the other way around.